進行したCoats病に対して、ブロルシズマブとレーザー光凝固療法を併用して治療した

Advanced Coats' disease treated with intravitreal brolucizumab combined with laser photocoagulation.

• Nimesh A Patel
• Audina M Berrocal
• Timothy G Murray
• Victor M Villegas

抄録

目的:

黄斑滲出物と浮腫の治療に抗VEGFブロルシズマブを初めて使用したCoats病患者の報告。

Purpose: To report the first use the intravitreal anti-VEGF brolucizumab for the treatment of macular exudates and edema in a patient with Coats' disease.

観察結果:

症例は9歳の男児で，右眼の視力低下を訴えて紹介された．診察時の視力は外径20/400、検査では末梢毛細血管拡張、滲出液、微小動脈瘤、黄斑浮腫、下側滲出性網膜剥離が認められた。Stage 3A2のCoats病と診断され，末梢ダイオードレーザーのほか，ベバシズマブの点滴静注治療を行った．しかし，その後の経過観察で網膜下液の持続と視力低下が認められた．この患者はその後、ブロルシズマブの眼内投与を受けた。注入後の視力と解剖学的な改善は著しく、2週間以内に黄斑浮腫は完全に消失した。5ヶ月間のフォローアップ期間中、体液の再蓄積はなく、それ以上の治療は必要ありませんでした。

Observations: A 9-year-old boy was referred with a decrease in vision in the right eye. Visual acuity was 20/400 OD on presentation, and examination was remarkable for peripheral telangiectasias, exudates, microaneurysms, macular edema, and an inferior exudative retinal detachment. A diagnosis of Stage 3A2 Coats' disease was made, and the patient was treated with intravitreal bevacizumab as well as peripheral diode laser. However, on follow up, there was persistence of subretinal fluid accompanied by a decrease in visual acuity. The patient was then treated with intravitreal brolucizumab. Post injection visual and anatomical improvements were significant with complete resolution of macular edema within two weeks. Throughout the 5 months of follow up, there has been no re-accumulation of fluid and no further required therapy.

結論と重要性:

Coats病の網膜浮腫および滲出物の治療にブロルシズマブの体外投与が有効であった。

Conclusions and Importance: Intravitreal brolucizumab was effective for the treatment of retinal edema and exudates in Coats' disease.

© 2020 The Authors.